A scoping review and thematic analysis of social and behavioural research among HIV-serodiscordant couples in high-income settings

Scoping reviews are used to map a field of study and to determine the value in undertaking further systematic reviews or studies by helping to identify important evidence gaps [15]. For this review, PRISMA guidelines were adopted and used to help standardize reporting [16]. Ten electronic databases (Medline, EMBASE, CINAHL, Cochrane Collaboration, JSTOR, PsychInfo, Scopus, Web of Science, Sociological Abstracts, and Social Work Abstracts) were searched from November to December 2012. Search terms included “human immunodeficiency virus”, “HIV”, “acquired immune deficiency syndrome”, “AIDS”, “relation”, “relationships”, “couple”, “marriage”, “partner”, “spouse”, “serodiscordan*” and their equivalent Medical Subject Heading (MeSH) terms. These terms were combined using the generic formula: “HIV” and “serodiscordant” and “relationship”. For a sample search strategy, please see Additional file 1. No restrictions were initially applied with respect to geographic location, date, or language. After removing duplicates and mapping recurrent themes [17], we opted to focus the review by excluding citations that were not reported in English, did not report primary data, were conducted in the pre-cART era (≤1996), reported exclusively on casual or undefined relationships, did not report on social or behavioural aspects, or were conducted in low and middle-income settings [18]. We reviewed each study at the full-text review stage for evidence of a distinction between primary (i.e., stable) and casual relationships and included any study that incorporated any fraction of couples or individuals who were engaged in a primary relationship. Studies of social and behavioural aspects were included, while those covering clinical or biomedical topics (e.g., sperm washing), were excluded. Research on biomedical prophylaxes (e.g., treatment-as-prevention, TasP, or pre-exposure prophylaxis, PrEP) were included if the work focused on social or behavioural aspects. We opted to distinguish low- and middle-income settings from high-income settings and to focus the present review on the latter, given that disparate resource levels contribute to distinct socio-structural environments worthy of separate consideration. Studies that identified their unit of analysis as either the dyad (i.e., both members of the couple), as the individual member of the couple, or both, were included in this review.

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